Endocrine Abstracts

Increased use of abdominal imaging has resulted in vast numbers of adrenal incidentalomas being identified (Bovio et al., 2006). Guidelines exist for identifying hormone excess and diagnosing malignancy but there is little evidence about how to manage phaeochromocytoma in patients who are poor surgical candidates. We present the case of a frail 88 year-old lady who was found to have a right adrenal incidentaloma during assessment for abdominal pain. Mrs R is able to m...

Postprandial Hyperinsulinaemic Hypoglycaemia reportedly occurs in 0.1 to 0.3% of patients after Roux-en-Y Bypass procedures. In our Bariatric Surgery Service we seem to be seeing this complication more frequently. Most patients can be managed in a step-wise approach, but we have a few patients who appear refractory to conventional treatment. This case illustrates one such patient. Mrs P was referred to the Weight Management service in 2011, aged 45. She weighed 108 kg, with a ...

Mr RP is a 69 year old gentleman who presented to A&E following a fall. He described several weeks of lethargy, ataxia, confusion and polydipsia. He had a past medical history of hypertension and COPD, but was otherwise fit and well. On admission bloods revealed an adjusted calcium of 5.25, with a PTH of 2.4. He also had a significant AKI with an eGFR of 22. After initial management with IV fluids, a cautious dose of pamidronate was given. Basic investigations did not iden...

A 50-year-old half Jamaican gentleman was referred urgently to the endocrinology clinic with thyrotoxicosis. He had lost 2 stone in weight over a 2 month period and was complaining of lethargy, low libido and loose stools. His bloods showed a fT4>100 pmol/l, fT3 32.7 pmol/l, and TSH <0.02mU/l. Subsequently his TSH-R Ab returned elevated at 5.5IU/l (<2.9IU/l), confirming a diagnosis of Graves’ disease. His GP also checked his testosterone level on the initial b...

Mrs MP was referred to the Weight Management service in 2011, aged 45. She weighed 108 kg, with a BMI of 40 kg/m2. She had type 2 diabetes, but no other past medical history and was working in a high profile job. A Roux-en-Y bypass was performed in November 2011, with no immediate complications. She successfully lost 25% of her body weight and by April 2012 weighed 79.2 kg. Towards the end of 2015 she was re-referred with symptoms of severe fatigue, poor concentrati...

There is limited evidence for the role of screening for Cushing’s syndrome (CS). Patients referred to the specialist medical weight management service at Musgrove Park Hospital have routinely been screened for CS with either an overnight dexamethasone suppression test (ODST) or two 24hour urinary free cortisol (UFC) if evidence of dysglycaemia. We retrospectively analysed the results of all patients referred to the service between 2013–2016. 794 patients were seen as...